violence

The President’s Podium: Physicians and Gun Violence II

Posted in Public Health, violence on February 13th, 2017 by MMS Communications – Comments Off on The President’s Podium: Physicians and Gun Violence II

by James S. Gessner, M.D., President, Massachusetts Medical Society

Last June, I devoted a President’s Podium to the subject of physicians and gun violence, noting our long-standing policy on firearm violence and the more recent efforts MMS has made to address this growing public health crisis.

Our latest activities include the creation of continuing medical education courses, based on content from our 2016 Public Health Leadership Forum, and a dedicated website at www.massmed.org/firearms, offering a variety of resources on firearm violence and gun safety.

Today I had the privilege of standing with Massachusetts Attorney General Maura Healey and Massachusetts law enforcement officials to announce new initiatives in enhancing provider-patient relationships regarding firearms. I take this space to share my remarks from the press conference with you.

Madam Attorney General, on behalf of the physicians of Massachusetts, I thank you for the invitation to co-sponsor and participate in today’s event.  It is an honor to stand here with you, other health care leaders, and law enforcement officials to remind everyone what has been evident for some time:  that gun violence is a major public health threat.

That physicians are collaborating in this event and are taking a stand against gun violence alongside law enforcement should not be considered unusual. For more than 20 years, our state medical society has been engaged in efforts to reduce violence in many forms. 

The physicians of our Committee on Violence Intervention and Prevention since 1995 have provided resources for both physicians, health care providers, and patients in such areas as intimate partner violence, bullying, child abuse, and human trafficking.  Gun violence has been prominent among those topics.


Physician efforts at gun violence have been directed at reducing deaths and injuries, making gun ownership safer, promoting education among health providers, and encouraging research to understand the risk factors related to gun violence.

The numbers alone make it abundantly clear that firearm violence is indeed a public health issue: more than 130 mass shootings have occurred in 39 states since 2009; more than 36,000 persons die from firearm injuries in the United States every year with 64 percent being suicides and 33 percent homicides; on an average day, more than 90 Americans are killed with guns, including seven children and teenagers; and for every person killed by a gun, two more are injured.  The number of deaths from firearms are rivaling those from motor vehicle accidents and in many states have surpassed vehicle fatalities.

Massachusetts, however, stands out, with the lowest gun death rate in the country for 2015, the last year for which statistics are available.  We may pride ourselves on having the lowest death rate, but let us remember that 213 people in Massachusetts still lost their lives to firearms in that year.    

Strong firearm laws have contributed to the state’s low death rate.  But awareness and education must also play important roles, and the Massachusetts Medical Society is pleased to continue its educational efforts in collaboration with Attorney General Healey’s office and law enforcement leaders across the state in educating individuals about safe storage and disposal of firearms, and in encouraging health care providers to talk to their patients about gun safety.  These efforts complement our Society’s continuing medical education courses on firearm violence.

Increasingly, physicians are making their voices heard about gun violence.

Two years ago, more than one dozen physician organizations, along with the American Public Health Association and the American Bar Association, issued a call to action, declaring that deaths and injuries from firearms are a major public health problem in the United States.  Last year, the American Medical Association adopted a policy calling gun violence in the United States a “public health crisis.”

Also last year, our medical society sponsored a public health forum on firearm violence, featuring community leaders and public health and law enforcement officials, and Attorney General Healey was kind enough to accept our invitation to be the keynote speaker for that event.

In her remarks, she highlighted the importance of physician participation in curbing gun violence, and said it will require a “partnership” with physicians.  Physicians agree, Ms. Healey, and I will conclude my remarks by saying “You can count on that.”  

The President’s Podium appears periodically on the MMS blog, offering Dr. Gessner’s commentary on a range of issues in health and medicine.

Pictured: Covers of brochures for patients and physicians/health care providers provided by the Massachusetts Office of the Attorney General and the Massachusetts Medical Society and endorsed by the Massachusetts Chiefs of Police Association and the Massachusetts Major City Chiefs of Police. Available free via download from www.massmed.org/firearms

 

December Physician Focus: Violence and Mental Illness

Posted in behavioral health, Health, mental health, Physician Focus, Public Health, violence on December 2nd, 2013 by MMS Communications – Comments Off on December Physician Focus: Violence and Mental Illness

Mass killings such as those at the Washington Navy Yard earlier this year and in Aurora, Colorado and Newtown, Connecticut last year continue to raise alarms about the link between violence and mental illness. A recent Gallup poll found that nearly half of Americans – 48 percent – blame the mental health system “a great deal” for mass shootings and for failing to identify individuals who are a danger to others.

The December episode of Physician Focus offers a perspective on the topics of violence and mental illness and explores the link between them.

Guests are John Bradley, M.D. (center, photo), Chief of Psychiatry and Deputy Director of Mental Health for the Veterans Administration Boston Healthcare System and former Chief of Psychiatry at Walter Reed National Military Medical Center, and Michael Tang, D.O., M.P.H. (right), psychiatry resident at Harvard South Shore Psychiatry, a program of Harvard Medical School. Hosting this program is John Fromson, M.D. (left), Vice Chairman for Clinical Affairs of the Department of Psychiatry at Brigham and Women’s Hospital and Chief of Psychiatry at Brigham and Women’s Faulkner Hospital.

Among the topics of conversation are the definitions of violence and mental illness, predictors and risk factors for violent behavior, the pervasiveness of violence in daily life, the role and impact of the media in covering violent acts, the relationship of violence to firearm access, and whether, as public opinion polls suggest, the mental health system has failed in identifying individuals who may commit violent acts.

Physician Focus is available for viewing on public access television stations throughout Massachusetts and online at www.massmed.org/physicianfocus and www.physicianfocus.org.

Israel Trauma Coalition Workshops This Week

Posted in Boston Marathon, Disaster Preparedness, violence on May 6th, 2013 by MMS – Comments Off on Israel Trauma Coalition Workshops This Week

In the wake of the Boston Marathon bombing, the Israel Trauma Coalition (ITC) is arriving in Boston and offering two free workshops (on May 7, 9 and 10, as described below).  The number of available slots is limited, so Massachusetts physicians with an interest in participating should sign up right away.

These workshops are co-sponsored by the Massachusetts Department of Mental Health (DMH) and Department of Public Health (DPH) in collaboration with the Executive Office of Health and Human Services (EOHHS).

Psychological First Aid & Resilience in the Aftermath of Terrorism (Workshop #1)

Workshop Summary: This workshop will discuss the impacts of disaster on individuals and communities, techniques for working with impacted populations, and when to triage individuals to additional support.  Attendees will also learn the importance of self care and the importance of resilience both individually and for a community.  The Israel Trauma Coalition will incorporate their own response experience into the training.

Target Group: Licensed mental health clinicians or individuals who have served as crisis counselors in emergencies

Dates: May 7th or 10th (9am – 3pm)

May 7 – Location & Registration

May 10 – Location & Registration

  •  Boston Medical Intelligence Center.  This is located within Boston EMS Headquarters, Miranda-Creamer Building, 35 Northampton Street, Boston MA.  As you enter the garage there will be a large blue sign that reads Miranda-Creamer Elevators and a blue door on your far right. Exit the garage through that door and take elevator to the 6th floor. Once off the elevators, go through the double doors to your right. The Lawlor Regional Medical Intelligence Center is the fourth door on the right.
  • Register for May 10th at: http://psychologicalresilience2.eventbrite.com

Introduction to Disaster Behavioral Health & the Impact Of Disaster On Communities (Workshop #2)

Workshop Summary: This workshop will provide an introduction to the psychological impacts of disaster on the community and how community members can assist individuals who have been impacted. A particular focus of the workshop will be the impact of terrorist events on immigrant communities.

Target Group: Social service employees, healthcare professionals, clergy and other natural helpers and community leaders

Date: May 9th (1 – 4pm)

Please Note:

  • Though registration is required, trainings are free and open.
  • Lunch will not be provided at these events.
  • CME credit will not be offered.
  • Free on site parking is available at the Westborough workshop.  $5 garage parking is available at the Boston Medical Intelligence Center.  Attendees to the Lindeman Center trainings are strongly encouraged to take public transportation.  Paid parking and limited on street metered parking is available.

For further information contact Liam Seward (Director of Program Implementation and Emergency Management, DMH): Liam.Seward@State.MA.US (617) 626-8170

About ITC

The Israel Trauma Coalition (ITC) was created in 2001, on the initiative of the UJA-Federation of New York. Expanding from Direct Care to encompass Professional Training, Community-wide Interventions and emergency preparedness, ITC has consistently evolved its scope to address broader issues and needs.

The mission of the Israel Trauma Coalition (ITC) is to create a continuum of care in the trauma field, response and preparedness, by leveraging diverse resources to initiate, prioritize, and optimize services. The ITC provides a comprehensive view of the trauma field, whilst working towards strengthening community resilience and ensuring national emergency preparedness. The ITC harnesses the collective knowledge, expertise and experience of Israel’s leading NGO’s and government organizations- as no organization can do this work alone.

Listening First Aid

Posted in Boston Marathon, mental health, Physician Health, Steve Adelman, violence on April 23rd, 2013 by MMS – 1 Comment

By Steve Adelman, MD

In the past two days, I have had the privilege of participating in two large support sessions for volunteers who witnessed the horrors at the Boston Marathon finish line. The sessions were organized by the Boston Athletic Association, in conjunction with the Massachusetts Department of Public Health.

The purpose of these events was to give stressed and  traumatized volunteers an opportunity to come together, share their experiences, and to commence the process of regaining a sense of emotional well-being after having served a sudden and unexpected tour of duty in an urban war zone.

Sunday’s session took place at the Boston Sheraton on Boylston Street, not far from the finish line. Monday’s session took place at the offices of the Massachusetts Medical Society and Physician Health Services, in Waltham.

Many affected volunteers at each session expressed feelings that they wish they had done more. Virtually everybody at the scene was thrust into a chaotic and unpredictable situation, one that nobody anticipated. In the minutes after the blasts, most everyone at the scene of carnage experienced serious challenges to their sense of being competent and effective.

Although the results speak for themselves – many, many lives and limbs were saved by a superlative team effort – the members of the team are all feeling pretty bad. It’s as if they were saying, “I have no idea how our team won on Monday, because I certainly could have played better.”

Many of the survivors described awkward conversations in the community and the workplace:  “People call me a hero, but I don’t feel like a hero.” It’s very difficult to feel incompetent and to be told that you are a hero.

Several survivors have learned that people out there “just don’t know what to say.” After the manhunt ended on Friday, a common comment they heard was, “You must feel better now.” But they didn’t feel better – many of them felt worse.

Question: How do we talk to people who have recently endured extreme trauma?

Answer: Very little – better to listen than to talk.

Listen very carefully, and try to put yourself in their shoes. Ask open-ended questions and respect their answers and wishes. Follow the lead of the person you are listening to. Here are a few questions and comments to consider utilizing if you undertake a conversation with a traumatized person:

  • Do you feel like talking?
  • What would you like to talk about?
  • Tell me more.
  • What was that like?

Don’t assume that you know how the other person feels, and don’t assume that their experience of the trauma is what you imagine it to be. By asking gentle, empathic questions, you can help the trauma survivor to unburden himself or herself, but only if he or she wants to.

As an empathic listener, your job is to follow the other person’s lead, never to take the lead. If the survivor you are with prefers to remain silent, that’s okay. Just let them know that you’re ready to listen if they ever feel like talking.

Gregorio Billikopf Encina of the University of California Berkeley has referred to this form of “empathic listening” as “listening first aid.”

Now that the acute trauma of the Marathon explosions is beginning to subside, let’s approach our conversations with the survivors – in our communities and throughout the health care system – in a low-key, respectful, and empathic way. By applying “Listening First Aid,” we can promote healing by helping them to feel understood, by trying, as best we can, to see the fractured world through their eyes.

Dr. Adelman is director of Physician Health Services, Inc., a corporation of the Massachusetts Medical Society. For more information, visit www.physicianhealth.org.

The Next Focus: Mental Health

Posted in Boston Marathon, mental health, violence on April 19th, 2013 by MMS – Comments Off on The Next Focus: Mental Health

Following a week of terror and tragedy, there will likely be a greater focus on the mental health needs of the community: Victims, family members, medical clinicians, first responders, volunteers, and spectators.

Some of the most common symptoms of mental health issues are likely to be difficulty sleeping, becoming easily frustrated or angry, and a diminished ability to focus on daily tasks.

Physician Health Services is available to physicians, to provide support, and, when appropriate, referrals to mental health professionals and other resources. Support groups for physicians are also available. PHS can be reached at (781) 434-7404.

The Mass. Department of Public Health is coordinating mental health services for the public through its website.

The Massachusetts Department of Mental Health offers an excellent list of web resources on mental health issues.

The heroic work of physicians, first responders and other medical personnel was broadly documented in the news media. Here is a sample of the many reports:

Like all of you, we are grateful that this nightmare is over. Let us expend our energy and focus our resources to help all those involved recover from this ordeal – physically and emotionally.

“This Too Shall Pass”

Posted in Boston Marathon, Physician Health, Steve Adelman, violence on April 19th, 2013 by MMS – Comments Off on “This Too Shall Pass”

By Steve Adelman, MD

The surreal situation unfolding today in Greater Boston will surely pass. In the meantime, a tsunami of images, directives, theories and fears is flooding the hearts and brains of our entire community. In this kind of atmosphere, those who are emotionally vulnerable are being whipped into a frenzy of stress, anxiety, and, in some cases, panic.

As physicians, we are uniquely qualified to help our community maintain a sense of proportion. We know how to stay calm in times of stress and strain; we know that the “tincture of time” is sure to heal in aberrant situations like this one.

The public looks up to us.  Let’s do our best to communicate a sense of calm and reassurance to all. Let’s use our knowledge, experience and professional perspective to help people maintain, or regain, their composure.

Dr. Adelman is director of Physician Health Services, Inc., a corporation of the Massachusetts Medical Society. For more information, visit www.physicianhealth.org.

At Our Best When the Worst Happens

Posted in Boston Marathon, violence on April 16th, 2013 by MMS Communications – 1 Comment

By Richard Aghababian, MD
President, Massachusetts Medical Society

It is an axiom in the profession of medicine, perhaps too often left unstated, that physicians, nurses, and health care workers are at their best when others are at their worst.

We saw this all too clearly yesterday, Patriots Day 2013, when Boston was shaken by bombings at the Boston Marathon.

As an emergency physician, I understand the value of preparedness for incidents like this. The capability to meet disasters is preceded by hours of preparation, planning, drills, and a motivation to be ready when and if needed.

Boston is a city known around the globe for its medical care, and it has shared its expertise with others whenever and wherever needed: after Superstorm Sandy, in Louisiana following Hurricane Katrina, in Haiti after the earthquakes, in New York City after September 11.

Yesterday, disaster and terror struck at home, and Boston’s first responders, emergency medical personnel, physicians, and hospitals across the city showed just how prepared we are for the unexpected and how quickly we can meet a challenge. They can be proud of their actions, and we should take pride in how they responded.

On behalf of the Massachusetts Medical Society, I offer my thanks to all of them. We are fortunate to have such dedicated medical and law enforcement professionals among us.

We are All Patients, We are All Healers

Posted in Boston Marathon, Physician Health, Steve Adelman, violence on April 16th, 2013 by MMS – Comments Off on We are All Patients, We are All Healers

By Steve Adelman, MD

Terrorism is a vile disease, and when this disease strikes civilized society as it has in Boston, we are all afflicted. A sudden explosion turns all of us, immediately, into patients.

In times of crisis like this, we are all in pain. We suffer together. Each and every one of us has been violated. Innocents have been slaughtered and wounded; lives have been permanently damaged; a day of joy and celebration has been transformed into a day of mourning.

The disease of terror is not a fatal one. We New Englanders are fighters and we are helpers, and within seconds of the Marathon explosions we went into “healing mode.” A photographer at the finish line used one hand to shoot pictures while, with the other hand, he tore down barricades to get to the wounded . Momentarily stunned medical personnel immediately transformed the first aid tent into a field hospital. Friends and family rallied to assist and reassure one another, taking advantage of technology to reconnect and begin bouncing back.

Some bounce back faster than others. Here are some readily available resources that may be of assistance:

Coping with Disaster
FEMA – Ready.gov

Managing traumatic stress: Tips for recovering from disaster and other traumatic events
American Psychological Association

Recovering Emotionally
American Red Cross

Disaster Distress Helpline (24/7 phone and text)
Substance Abuse Mental Health Services Administration

Kevin Kennedy, Ph.D., is a Chief of Behavioral Health at Harvard Vanguard Medical Associates and a highly-regarded expert in parenting. I asked Dr. Kennedy to provide some practical parenting tips to guide us in talking to our children about the disaster in Copley Square. Here’s his advice:

“Events like the tragedy at the Boston Marathon cause children to feel vulnerable and unsafe. This is unavoidable. It is important that parents be realistic about the fact that some people do bad things but that most people are nice.

“Children are reassured by order and structure, so it helps to maintain the usual schedule of routines and activities in the family. In an environment of 24-hour news, parents can help children by limiting their exposure to excessive television coverage. Repetition of troubling videos can convey a disproportionate degree of danger.

“For much the same reason, parents should limit the amount of conversation about the tragedy in the presence of their children. Be sure to ask if the children have any questions and be alert to their concerns. Don’t be surprised if they want to remain close to home and need more than the usual attention or reassurance.

Above all, parents can assure children of their love and affection and their intention to take good care of them.”

Dr. Adelman is director of Physician Health Services, Inc., a corporation of the Massachusetts Medical Society. For more information, visit www.physicianhealth.org.

March Physician Focus: Youth Violence and Child Abuse

Posted in gun control, mental health, Physician Focus, Public Health, violence on March 1st, 2013 by MMS Communications – Comments Off on March Physician Focus: Youth Violence and Child Abuse

As spectators, perpetrators, or victims, violence and abuse take a huge toll on our nation’s youth.  The numbers are stark and telling.

Homicide and suicide are the second and third leading causes of death of American children.  More than 707,000 youth ages 10-24 receive  emergency treatment for injuries from physical assaults, and more than three million reports of child abuse are filed each year – an average of nearly six every minute.

While the numbers show the size of the problem, news reports depict the tragedy.  The pictures and reports of such places as Columbine, Newtown, and Virginia Tech, and widespread abuse by clergy and coaches are now vivid and sad chapters in our nation’s history.  And they continue to make headlines.

The March edition of Physician Focus attempts to put some perspective on the topic of youth violence and abuse with Robert Sege, M.D. (center, photo) and Elliot Pittel, M.D. (right)  joining program host Bruce Karlin, M.D. (left) for discussion.

Dr. Sege is Director of the Division of Family and Child Advocacy at Boston Medical Center, a member of the American Academy of Pediatrics’ Committee on Child Abuse and Neglect, and co-author of the AAP’s policy on guns.  Dr. Pittel is a child and adolescent psychiatrist at The Home for Little Wanderers in Boston and chair of the MMS Committee on Violence Intervention and Prevention.

Among the topics of conversation are the causes of youth violence, the influence of media on children, the importance of ‘being connected’ for both parents and children, and the role physicians can play in helping to prevent and reduce the violence.

Physician Focus is available for viewing on public access television stations throughout Massachusetts and also available online at www.physicianfocus.org. and on iTunes at www.massmed.org/itunes.

 

MMS Urges Parents: Learn More About Child Sexual Abuse

Posted in Primary Care, Public Health, Uncategorized, violence on February 27th, 2013 by MMS Communications – Comments Off on MMS Urges Parents: Learn More About Child Sexual Abuse

As reports of child sexual abuse increase at Massachusetts schools and with the Penn State and church pedophile scandals still in memory and making headlines, the Massachusetts Medical Society is encouraging parents and guardians to learn more about child sexual abuse with the publication of Protecting Your Child from Sexual Abuse, a collaborative effort with Massachusetts Citizens for Children.

This free 12-page brochure includes basic information on child sexual abuse; tips to help protect children; potential signs and changes in behavior to look for; what to do if abuse is suspected; and resources on reporting, preventing, and treatment of child sexual abuse.

Authored by Jetta Bernier, executive director of MCC, Protecting Your Child from Sexual Abuse is the result of a cooperative effort between the MMS Committee on Violence Intervention and Prevention and MCC, a nonprofit, independent advocacy group for the state’s most vulnerable children. It is one of a series of ten brochures focusing on various aspects of violence and children originated by Robert Sege, M.D., Director of the Division of Family and Child Advocacy at Boston Medical Center and a member of the American Academy of Pediatrics Committee on Child Abuse and Neglect.

The series of brochures is part of the Massachusetts Medical Society’s Campaign Against Violence and includes individual descriptions of such topics as dating and street violence, violence in the media, bullying, violence in the home, and myths and facts about violence.

Protecting Your Child from Sexual Abuse and the other brochures in the series are available free via download from the Massachusetts Medical Society at www.massmed.org/violence. Printed copies may be ordered individually or in sets from the Medical Society by writing to dph@mms.org or calling 1-800-322-2303, Ext. 7373.